Letter

354 http://ap.psychiatryonline.org Academic Psychiatry 28:4, Winter 2004

ACGME Research Requirementsfor Residents in Psychiatry

To The Editor: Recent efforts bythe Accreditation Council for

Medical Education (ACGME) to ex-pose psychiatry residents to a re-search experience during their 4years of training has been problem-atic for many predominately clinicalprograms. A debate about how toeffectively engage psychiatric resi-dents in research is ongoingthroughout academic institutions.In the Department of Psychiatry andHuman Behavior at Thomas Jeffer-son University, we developed a re-quired 7-week, 1-day per week re-search rotation during which PGY-3residents are asked to write a pro-posal. From our experience, wefound that residents have manyquestions emanating from theirclinical experiences. Our approachis threefold: First, residents developand refine a clinical question of in-terest to them and, with our sup-portive guidance, formulate a hy-pothesis. Second, they are asked toperform a limited literature searchand this material is discussed witha member of the faculty. Third, theycomplete our Institutional ReviewBoard Forms and a brief proposal toanswer their query. The proposal in-cludes sections on background andsignificance, specific aims, popula-tion characteristics, and subject con-sent procedures, all of which helpthe residents to focus and expresstheir ideas in a practical format.Throughout the preparation andcompletion of their research rota-tion, we meet with the residents todiscuss the write-up and feasibilityof their proposal (about 45 minutesper week). The required rotation

contains aspects of the ACGMEguidelines in that the rotation helpsto foster the development of skillsrequired to conduct research. Ourgoal is to foster the development ofsome research skills by having theresidents answer a clinical questionof interest to them.

Competency rating for the ac-tivity was problematic. Initially, wetried to use Thomas Jefferson’s stan-dard Clinical Rotation Form, but itdid not capture the research activityresidents experienced on the rota-tion. To address this problem, wegenerated a list of research perfor-mance items categorized accordingto the ACGME General Competen-cies:

Research Competency Checklist

A. Knowledge• Does the resident under-

stand how to generate a researchquestion?

• Does the resident demon-strate knowledge of research meth-ods?

• Does the resident under-stand how to focus a research ques-tion?

B. Evidence-base learning andimprovement

• Can the resident utilize re-search staff to improve knowledgeand skill?

• Can the resident search lit-erature and use the information toguide their project development?

• Can the resident recognizeand learn from his/her own efforts?

• Has the resident demon-strated interest and involvement inscholarly activities such as presen-tations and publications?

C. Interpersonal skills• Can the resident negotiate

mutually agreeable goals with theresearch supervisor?

• Can the resident work effec-tively with other professionals toconduct research in outpatient set-tings?

• Can the resident present theresearch proposal and results in awell-organized, clear, and appro-priate manner?

D. Professionalism• Does the resident recognize

ethical issues in research?• Does the resident maintain

adequate documentation and re-sults, including adverse events, forclinical research?

• Is the resident reliable, re-sponsible, and considerate in car-rying out research responsibilities?

E. System-based paractice• Is the resident aware of the

social and financial resources nec-essary to conduct research?

• Can the resident work effec-tively in a multidisciplinary team?

• Has the resident prepareddocumentation suitable for reviewby the Institutional Review Board?

We find this approach to be arewarding experience for the resi-dents. Of the five residents whohave completed this rotation, fourresidents plan to complete their re-search proposals during an electivein their fourth year of training.

Kathleen S. Peindl, Ph.D.Steven Weinstein, Ph.D.Ashwin A. Patkar, M.D.Edward Silberman, M.D.

Michael Vergare, M.D.Thomas Jefferson University, Department

of Psychiatry and Human Behavior,Philadelphia, Pennsylvania